Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1386395770 |
---|---|
Provider Name | Joanna Lam |
First Address | San Francisco, CA 94134-1233 |
Second Address | Hayward, CA 94541-7708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2022 |
Last Update Date | 17/01/2022 |